Neuromyelitis optica in a young male patient: a case report and literature review

Abstract

Introduction and importance: Neuromyelitis optica (NMO) is a rare immune-mediated neurologic disease with female predominance with a 9:1 ratio, with an average age of 40 years. It is uncommon in males and young patients. Case presentation: A 23-year-old male from Ethiopia presented with progressive leg weakness, which escalated to include other symptoms like cough, shortness of breath, and vision problems. Neurological exam revealed specific deficits including leg paralysis, arm weakness, and sensory loss up to the mid-chest. Based on these symptoms and magnetic resonance imaging (MRI), he was diagnosed with neuromyelitis optica spectrum disorder (NMOSD), treated successfully with steroids and azathioprine, and improved. Case discussion: NMO is rare autoimmune central nervous system disease with severe symptoms (spinal cord, optic nerve, brainstem). NMO is usually common in females (9:1) around age 40. NMOSD is rare (low incidence/prevalence), but risk varies: higher mortality/risk in African and Asian populations. The diagnosis of NMOSD can be diagnosed based on the 2015 international consensus diagnostic criteria. Conclusion: Even though Neuromyelitis Optica is a rare immune-mediated neurologic disease, and even more uncommon in young male individuals, it can occur and be diagnosed by clinical criteria with or without AQP4-antibodies plus consistent MRI findings.